What are the responsibilities and job description for the Medical Collections Representative position at NexGen Orthopedic Health & Wellness?
Job Overview
We are seeking an experienced and detail-oriented Medical Collections Representative with strong expertise in out-of-network (OON) insurance claims follow-up and collections. The ideal candidate will have a proven track record of aggressively pursuing outstanding insurance balances, resolving denied or underpaid claims, and maximizing reimbursement from commercial payers.
Location: Paramus, NJ
Schedule: Monday- Friday/ 8-hour shift
Responsibilities
- Perform comprehensive follow-up on outstanding out-of-network medical claims
- Contact insurance carriers regarding claim status, denials, appeals, and underpayments
- Investigate and resolve billing discrepancies and payment issues
- Submit corrected claims, reconsiderations, and appeals as needed
- Maintain accurate documentation of all collection activities and payer communications
- Work aging reports and prioritize high-dollar accounts
- Identify trends in denials and reimbursement issues
- Collaborate with billing and credentialing teams to improve claim resolution
- Ensure compliance with HIPAA and all applicable healthcare regulations
Requirements
- Minimum 2 years of medical collections and insurance follow-up experience
- Strong knowledge of out-of-network billing and reimbursement processes
- Experience working with commercial insurance payers
- Familiarity with appeals, denials management, and EOB interpretation
- Excellent communication and negotiation skills
- Strong organizational skills and attention to detail
- Ability to work independently and meet collection goals
- Experience with EMR/billing systems preferred
Compensation & Benefits
- Competitive salary based on experience
- Performance incentives/bonus opportunities
- Health benefits and paid time off
- Opportunities for growth and advancement
Apply today if you are a motivated collections professional who thrives on recovering difficult out-of-network claims and maximizing reimbursements
Pay: $20.00 - $25.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Experience:
- medical collections and insurance follow-up: 2 years (Required)
- out-of-network billing and reimbursement processes: 2 years (Required)
Work Location: In person
Salary : $20 - $25